Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | ME102340 | FL |
N | 2080P0203X | Pediatric Critical Care Doctor | 036.130273 | IL |
N | 2080P0203X | Pediatric Critical Care Doctor | ME 102340 | FL |
NPI | 1215154943 |
---|---|
Provider Name | Juan Carlos Meneses Paz |
First Address | Miami, FL 33155-3009 |
Second Address | Miami, FL 33155-3009 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2007 |
Last Update Date | 26/11/2013 |